Lecture 17 PowerPoint

Lecture 17 PowerPoint - Crisis Intervention Crisis...

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Unformatted text preview: Crisis Intervention Crisis Intervention N310 Unit VII Lecture 17 Graham J McDougall Jr. With special thanks to Jan Fox RNC, MSN Stella Logan MSN, RN, PMHCNS­BC Veronica Garcia Walker MSN, RN, BC Definition Definition • A crisis is a sudden change in a person’s life situation or status during which: 1. customary methods of coping or problem solving fail or are inadequate 2. resulting in feelings of anxiety, disequilibrium, or depression. • Crisis is a self­limiting state and will generally resolve in 4­6 weeks. Types of Crisis Types of Crisis • Developmental or Maturational (role changes) • Situational (Loss of a job) • Adventitious (Accident, uncommon, fire, plain crash) What is Crisis Intervention? What is Crisis Intervention? • Crisis intervention is a specific brief therapeutic technique designed to enhance coping and restore a person to his/her prior level of functioning. Sequence of Crisis Sequence of Crisis Development The Pre­crisis period is marked by: – Emotional equilibrium – Effective coping mechanisms Sequence of Crisis Sequence of Crisis Development Features of the crisis period include: – Upset in equilibrium – Rise in tension and anxiety – Usual coping skills are not successful Sequence of Crisis Sequence of Crisis Development Post crisis period involves: – Return to usual level of functioning (pre­crisis state), decreased anxiety, reestablish equilibrium – Resolution of crisis Characteristics of Crisis Situations Characteristics of Crisis Situations and Crisis Intervention • Physiological: Signs of anxiety include: – 1. diarrhea, dizziness, shortness of breath, palpitations – 2. Sleep disturbance – 3. Restlessness, lack of concentration – 4. Irritability, outbursts of anger – 5. Agitation, crying Characteristics of Crisis and Characteristics of Crisis and Intervention: Psychological symptoms include: – 1. Inability to make decisions – 2. Feeling of isolation – 3. Suicidal and homicidal ideation Because a patient in crisis feels… Because a patient in crisis feels… Overwhelmed and unable to cope, effective crisis intervention must build on the patient’s existing strengths and resources. Due to the high level of anxiety: Due to the high level of anxiety: • A patient may feel he is going “crazy”. The individual needs to be told that when he feel less anxious he will be able to think clearly again. The initial goal of crisis intervention The initial goal of crisis intervention is to: Decrease anxiety!!!! Principles of Crisis Intervention Principles of Crisis Intervention A. Emphasizes healthy aspects of the B. C. personality rather than pathology—(what skills does the person have that can be useful in coping?) Focuses on the social structure of the individual rather than the dynamics of personality. (Assumes the person will make the right decision if given information and support) Uses a directive approach—(give them a meal voucher, give them a place to stay) Treatment Treatment • Crisis counseling is: – Short term – usually 4­6 weeks. – Focused on the immediate crisis. – Effective with individuals, groups, or families. Steps in Crisis Intervention Steps in Crisis Intervention A. Assessment 1. 2. 3. What happened? (What brought you here today?) When did it happen? Patient’s perception of the event? (Is this realistic or unrealistic?) 4. Available situational supports? 5. Coping skills? (Has anything like this happened to them before? How did they cope then?) 6. Safety? (Suicidal? Homicidal?) Available support systems: Available support systems: • • • • Who do you live with? Who is your best friend? Who do you trust? What family members are you closest to? Coping Skills Coping Skills • How do you normally relieve anxiety/stress? • What have you tried this time? • Did it work? What is the reason it did not? ( If it did not) • What do you think would relieve your distress now? Is the individual suicidal or Is the individual suicidal or homicidal? • Are you thinking of hurting yourself or • • • • • someone else? What are you thinking? Do you have a plan? How? When? Have you had any previous attempts to hurt yourself or others? What ? When? Steps in Crisis Intervention Steps in Crisis Intervention B. Diagnosis What type of crisis is it? 1. 2. 3. 4. Maturational/Developmental? Situational (Life event)? Adventitious (Accidental) ? Mixed types? C. Planning & Intervention 1. Define the problem. (What is the 2. 3. problem?) Explore alternative solutions (What can we do?) Provide specific direction regarding strategies to relieve symptoms and restore coping. (Be directive) Evaluation Evaluation • Each session should conclude with an evaluation of progress, and adjustments in therapy should be made to address ongoing symptoms. • Crisis Hotline in Austin: 472­HELP Use the Process Use the Process • I am a newlywed and my husband has just slapped me. My spouse has told me that he is filing for divorce. I cannot sleep. I feel like I am a failure. Steps in Crisis Intervention Steps in Crisis Intervention A. Assessment 1. 2. 3. What happened? (What brought you here today?) When did it happen? Patient’s perception of the event? (Is this realistic or unrealistic?) 4. Available situational supports? 5. Coping skills? (Has anything like this happened to them before? How did they cope then?) 6. Safety? (Suicidal? Homicidal?) Steps in Crisis Intervention Steps in Crisis Intervention B. Diagnosis What type of crisis is it? 1. 2. 3. 4. Maturational/Developmental? Situational (Life event)? Adventitious (Accidental) ? Mixed types? C. Planning & Intervention 1. Define the problem. (What is the 2. 3. problem?) Explore alternative solutions (What can we do?) Provide specific direction regarding strategies to relieve symptoms and restore coping. (Be directive) ...
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This note was uploaded on 03/17/2012 for the course N 310 taught by Professor Fox during the Fall '08 term at University of Texas at Austin.

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